MEDICARE: SHEMISE MICHAEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	91518	TX

General Provider Information

NPI Number	:	1144090689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEMISE MICHAEL

Provider Business Mailing Address
First Line	:	2810 FEATHER GREEN TRL
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-7152
Country	:	US
Telephone Number	:	281-235-2375
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 FEATHER GREEN TRAIL
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545
Country	:	US
Telephone Number	:	281-235-2375
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	03/03/2025

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